Mar 022009
 

I don’t know about you, but getting a blood test used to be as easy as going to your favourite lab, getting your arm poked (ouch!), not watching the red fluid ease up the tube, ripping off the band-aid, waiting for the test results, getting a copy from your GP, and then reading the name of the lab at the top and then all the info underneath. Well, the bureaucrats have improved it.

First off, your favourite lab may now be out of bounds: Your doctor insists you go to his favourite lab or yours may have new rules about who can see them. The Toronto General Hospital (TGH) has the best vampires bar none, but since a year ago, they test only those who have TGH-based doctors. So now I get to choose between labs that don’t believe in using butterfly needles (or even know what they are), are a bit laissez faire about the whole hygiene thing, treat you like a number, or set it up to ease germs getting human passage from one place to another (yes, Mount Sinai hospital I’m talking about you with your gross number machine).

And second, the lab you went to may not be the lab that tests your fluids. Huh, I can hear you ask? Yes, the lab that pokes your arm is not the lab that tests your blood. The lab name at the top of the results sheet is where you went; now insterspersed among the information below are the names of the labs where your blood went. Which begs the question: if I go to private Lab A who then sends my blood to TGH, why the heck couldn’t I have gone to TGH in the first place?! The real killer for me though was the 24-hour urine test.

So OK, doctors at Mount Sinai like me to use the dirty-waiting-seat-gross-number-machine-averse-to-butterfly-needles lab there cause they like consistent results from one lab, the lab they know and trust, the Mount Sinai lab. I had wanted to use TGH, got my way with the doctor, but then TGH promptly said nah-uh, yet gave me the, ahem, testing jugs. I brought them to Mount Sinai, and the lady behind this enormous counter, the back of which she couldn’t reach and was the part closest to me, said, “don’t put that on my desk!” as I rested the jug inside a closed bag, inside a shopping bag (see, those plastic bags have uses) on the back of the desk. Yet she takes those number slips from patients’ hands. Go figure. Then she’s not sure Mount Sinai can test those jugs cause, well, they’re not Mount Sinai jugs. Oh brother. After much toing and froing, warnings and admonishments, and me pasting on of labels, I’m free to leave them as far away from her as I possibly can. I don’t remember any other lab person being so finicky, but then those labs call you by name and don’t have germy number machines. So weeks later, I get the test results back. Guess what? Mount Sinai did none of the testing. Nope, none. Two other hospitals did, one of which was Sick Kids. Sick Kids???

So, what the heck was all that botheration about? Does it really matter where I go? Does TGH’s new restrictive policy really make a difference to its workload when Gamma-Dynacare sends blood to them for testing, when at least one hospital doesn’t even do all its own testing, when bodily fluids are now making the downtown rounds in vans and trucks on public roads from one place to another, from one hospital to another? (Yes, that medical lab van next to you has blood in it. Don’t hit it now!) And I have to wonder about how consistent results can be over time with this merry-go-round testing when some doctors claim that tests are so sensitive that the variation between labs can cause them to prescribe incorrect medication levels and that’s why they want you to go to the same lab, their lab. Their preference is also true for other kinds of testing, but I’ve recently noticed that stress test reports vary markedly from one place to another, such that a complete report from one place makes you notice how incomplete the summary report is from Mount Sinai.

It seems to me that the bureaucrats and bean counters have created jobs for themselves by taking over the medical labs; they are not only costing us good customer service, but may also be skewing results due to lab variation unbeknownst to the doctors who blissfully still count on their own lab to do all the testing. It used to be I didn’t think about the testing labs; I assumed they were all good. But now I wonder. I wonder too if I need to acquaint myself with which labs are good and which not, which labs test my samples, and which outsource. And I also wonder when it comes to tests of all kinds, how good is my health care, really?

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  • Blood is the Life

    Any update on this? Who’s good and who’s bad?

  • Blood is the Life

    Any update on this? Who’s good and who’s bad?

  • Shireen

    I’ve discovered private labs can vary widely in hygiene and competence even within the same lab. One tech will glove up and be careful of what she touches; another will ignore all hygiene protocols. One knows to go for the good vein; another eyeballs the superficial veins which hurt like hell when poked — so you gotta say no forcefully and know your best veins. Not all private labs seem to have the butterfly needles, or maybe they hide them. Sometimes they can be vigilant about doing timed tests exactly when supposed to; other times they treat it like just any test that can be taken any time. Some doctors are computerized and so can receive tests electronically and have them available right in front of them on their laptop when they’re talking to you; others still use the paper method. Labs commonly “forget” to send all the results when you have multiple blood tests. I just spent an afternoon trying to get the two forgotten tests sent to the doctors. And the thing was the ordering doc never noticed the results were missing. Wassap with that?!

    Also, you’re not entitled to receive your test results directly from the lab. But if you ordered the tests from a US certified testing lab, you can. I wonder who made up the rule in Canada that you’re not allowed to see or receive information directly about your own body?

    I’ve also discovered that when it comes to testing, doctors really don’t know about how medications and food can interfere with results, and so it behooves the patient to look up American lab testing websites where they tell you what you may have to stop taking or avoid eating and drinking. Also, it seems that the labs here aren’t in the vanguard of testing technology, not when it comes to hormones anyway. (And that makes me wonder what else.) Here, they’re testing blood at one time of the day when perhaps testing saliva at four different times of the day would give a better picture. I don’t even know if doctors here know about the saliva tests or if you can even get them.

    And lastly, doctors don’t always know what tests you have to pay for. They blithely requisition tests and you toddle off to the lab, only to be told you’ll have to pay, like really pay, for one or more of the tests. And then, if funds are tight, you have to instantaneously try to figure out whether this test is all that important or not because, you know, docs don’t take phone calls and more often than not, secretaries don’t pick up but let calls go to voice mail, and so it’s not like you can discuss it with the doctor while you’re at the lab. I personally would like to never see the inside of a lab again.

  • Shireen

    I’ve discovered private labs can vary widely in hygiene and competence even within the same lab. One tech will glove up and be careful of what she touches; another will ignore all hygiene protocols. One knows to go for the good vein; another eyeballs the superficial veins which hurt like hell when poked — so you gotta say no forcefully and know your best veins. Not all private labs seem to have the butterfly needles, or maybe they hide them. Sometimes they can be vigilant about doing timed tests exactly when supposed to; other times they treat it like just any test that can be taken any time. Some doctors are computerized and so can receive tests electronically and have them available right in front of them on their laptop when they’re talking to you; others still use the paper method. Labs commonly “forget” to send all the results when you have multiple blood tests. I just spent an afternoon trying to get the two forgotten tests sent to the doctors. And the thing was the ordering doc never noticed the results were missing. Wassap with that?!

    Also, you’re not entitled to receive your test results directly from the lab. But if you ordered the tests from a US certified testing lab, you can. I wonder who made up the rule in Canada that you’re not allowed to see or receive information directly about your own body?

    I’ve also discovered that when it comes to testing, doctors really don’t know about how medications and food can interfere with results, and so it behooves the patient to look up American lab testing websites where they tell you what you may have to stop taking or avoid eating and drinking. Also, it seems that the labs here aren’t in the vanguard of testing technology, not when it comes to hormones anyway. (And that makes me wonder what else.) Here, they’re testing blood at one time of the day when perhaps testing saliva at four different times of the day would give a better picture. I don’t even know if doctors here know about the saliva tests or if you can even get them.

    And lastly, doctors don’t always know what tests you have to pay for. They blithely requisition tests and you toddle off to the lab, only to be told you’ll have to pay, like really pay, for one or more of the tests. And then, if funds are tight, you have to instantaneously try to figure out whether this test is all that important or not because, you know, docs don’t take phone calls and more often than not, secretaries don’t pick up but let calls go to voice mail, and so it’s not like you can discuss it with the doctor while you’re at the lab. I personally would like to never see the inside of a lab again.

  • Anonymous

    I wish they would keep a list of all the places you can go. They gave me a short list at Mt. Sinai on a sheet of paper with several downtown locations. But that was a while ago. I’m trying to find similar info online and nothing. I got a referral from my doctor for a blood test and still can’t figure our where to go with it. Shouldn’t this type of information be on the Ministry website? If it is, I sure as hell could not find it. Rankings and reviews might be nice too.

    I’ve never heard of a butterfly needle until now. I don’t know what the advantage is, but I think the regular ones are just fine.

  • Anonymous

    I wish they would keep a list of all the places you can go. They gave me a short list at Mt. Sinai on a sheet of paper with several downtown locations. But that was a while ago. I’m trying to find similar info online and nothing. I got a referral from my doctor for a blood test and still can’t figure our where to go with it. Shouldn’t this type of information be on the Ministry website? If it is, I sure as hell could not find it. Rankings and reviews might be nice too.

    I’ve never heard of a butterfly needle until now. I don’t know what the advantage is, but I think the regular ones are just fine.

  • Each hospital or doctor has their preferred private lab. It’s a good idea to ask which one and for the website address. A google search will bring up the lab’s website if your doc’s office can’t be bothered knowing and giving you the address. But gotta say some websites don’t make it easy to find their locations but they are there. Rankings and reviews on the Ministry site is a great idea.

    If your veins are fine, you don’t need a butterfly needle with its smaller size. But if you have flat or small veins, had many blood tests, or find having blood taken difficult, then they’re a god-send.

  • Each hospital or doctor has their preferred private lab. It’s a good idea to ask which one and for the website address. A google search will bring up the lab’s website if your doc’s office can’t be bothered knowing and giving you the address. But gotta say some websites don’t make it easy to find their locations but they are there. Rankings and reviews on the Ministry site is a great idea.

    If your veins are fine, you don’t need a butterfly needle with its smaller size. But if you have flat or small veins, had many blood tests, or find having blood taken difficult, then they’re a god-send.

  • Anetca

    You’re so right. And I got my doctor to specify “copy to patient” but when I went to the lab just south of St Mike’s they said that the Ministry of Health didn’t allow them to do that . So I took my requisition back and told them I did not believe that at all.

    Lazy sods

    Now I need a lab at North York City Centre

    Annette

  • Annette: I was told that too. I don’t get it. We patients are entitled to see our medical records (though too many docs don’t seem to know that) but can’t get our test results directly like patients in the US can? Smacks of big bro, paternalistic thinking. Nuts to that.

    LOL @Lazy sods! Yup, that too!

  • cesca_nz

    What pisses me off is that I cannot get the antibodies tests I desperately need, because my TSH is normal, so the doctor says I dont need the tests I am asking for. I cannot get treatment and get better if I dont have these antibody tests. It pisses me off that the doctors refuse to LISTEN to the patients!!!! There are some times when the patient DOES know more than the doctor. Being a Thyroid patient is one of them.

  • JPCactus

    I’ve been having exactly the same problem in Saskatoon until I found a new doctor fresh out of med school who is eager to be liked, she listens and is knowledgable and seems to have missed those classes where they’re taught to be arrogant SOB’s.

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